Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany; Center for Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Department of Neuroradiology, University Hospital Munich (LMU), Munich, Germany.
World Neurosurg. 2019 Jun;126:e965-e974. doi: 10.1016/j.wneu.2019.02.198. Epub 2019 Mar 12.
Woven Endobridge (WEB) embolization is an approved technique for endovascular treatment of wide-necked and bifurcation aneurysms. However, the WEB has not yet been routinely used for internal carotid artery (ICA) sidewall aneurysms. In this multicenter study, we evaluate the safety and efficacy of WEB for treatment of these aneurysms.
We reviewed all patients with ICA sidewall aneurysms who were treated with WEB at 3 German neurovascular centers between 2011 and 2018. Technical success, complication rates, and angiographic outcome were retrospectively assessed.
Twenty patients (mean age, 56.3 ± 13.0 years) with 20 ICA aneurysms (6 ruptured) were identified. The aneurysms were located at the paraophthalmic segment (n = 10), the posterior communicating artery segment (n = 9), and the anterior choroidal artery segment (n = 1). The mean aneurysm size was 8.1 ± 5.2 mm and 60% were wide-necked. The aneurysms were treated with a single WEB (n = 11) or in combination with coiling and/or stent implantation (n = 7). WEB implantation failed in 2 aneurysms because of a sharp aneurysm angle. There were 1 periprocedural thromboembolic event and 1 in-stent stenosis at follow-up, which remained asymptomatic in both cases. There was no procedure-related morbidity and mortality. At follow-up, complete occlusion was achieved in 76.5%, neck remnants in 17.6%, and aneurysms remnants in 5.9%.
The WEB device can be used for treatment of ICA sidewall aneurysms with a high level of procedural safety and a high degree of technical success.
编织型 Endobridge（WEB）栓塞术是一种已被批准用于治疗宽颈和分叉部动脉瘤的血管内治疗技术。然而，WEB 尚未常规用于颈内动脉（ICA）侧壁动脉瘤的治疗。在这项多中心研究中，我们评估了 WEB 治疗这些动脉瘤的安全性和有效性。
我们回顾了 2011 年至 2018 年间在德国的 3 个神经血管中心接受 WEB 治疗的所有 ICA 侧壁动脉瘤患者。回顾性评估技术成功率、并发症发生率和血管造影结果。
共纳入 20 例（平均年龄 56.3 ± 13.0 岁）20 个 ICA 动脉瘤（6 个破裂）患者。动脉瘤位于眶后段（n=10）、后交通动脉段（n=9）和脉络膜前动脉段（n=1）。平均动脉瘤大小为 8.1 ± 5.2mm，60%为宽颈。11 例采用单个 WEB 治疗，7 例联合弹簧圈和/或支架植入治疗。由于动脉瘤角度尖锐，2 个动脉瘤 WEB 植入失败。2 例患者在围手术期发生血栓栓塞事件，1 例在随访时出现支架内狭窄，但均无临床症状。无与手术相关的发病率和死亡率。随访时，完全闭塞率为 76.5%，瘤颈残留率为 17.6%，动脉瘤残留率为 5.9%。
WEB 装置可用于治疗 ICA 侧壁动脉瘤，具有较高的手术安全性和技术成功率。
